目的 分析改良式腹膜外剖宫产术的临床作用效果.方法 将2017年1月～2018年9月期间我科室收治的86例剖宫产产妇按照生产方式分为研究组及对照组,研究组42例采取改良式腹膜外剖宫产,对照组44例采取腹膜内剖宫产,比较分析剖宫产具体情况.结果 两组分娩时间、术中出血量、新生儿体重及新生儿窒息发生率差异不显著;研究组术后排气时间明显短于对照组;观察组术后发病率为7.1％,对照组为4.5％,差异不显著.结论 改良式腹膜外剖宫产术具有传统腹膜内剖宫产术的效果,并且术后产妇恢复更快,临床可根据产妇具体情况优先选择.

目的 探究缬沙坦对于老年高血压合并持续性房颤的治疗效果.方法 从2016年4月～2017年8月到我院进行治疗的病患中随机选出110例,平均分为两组,对照组使用胺碘酮进行治疗,观察组在对照组的基础上加入缬沙坦进行治疗,治疗后对比两组病患左心房内径和窦性心律维持率.结果 治疗后两组病患左心房内径均有所降低,但观察组左心房内径(34.68±13.37)mm小于对照组(42.84±14.76)mm,差异明显(P<0.05),治疗后观察组窦性心率维持率80％大于对照组50.9％,差异明显(P<0.05).结论 缬沙坦对于来年高血压合并持续性房颤的治疗效果显著,能够帮助病患维持窦性心率,提高转复率.

Objective To investigate the influence of Danhong Injection combining external counterpulsation (ECP) on inflammatory factors in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).Methods The patients (n=118, male 68 and female 50) were chosen from Nov. 2012 to Aug. 2014, and divided randomly into group I (n=38), group II (n=40) and group III (n=40). All groups were given routine treatment (including aspirin, clopidogrel, statins, ACEI, ARB, β-receptor blockers, nitrates and low molecular weight heparin). Group I was given routine treatment only, group II was additionally given 0.9% sodium chloride injection (250 mL) or 5% glucose (250 mL) and Danhong Injection (40 mL), and group III was additionally given 0.9%sodium chloride injection (250 mL) or 5% glucose (250 mL) and Danhong Injection (40 mL) and ECP (1 h/time, 1 time/d) for 14 d. The levels of high-sensitivity C-reactive protein (hs-CRP), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were detected 1 d before PCI, 1 d after PCI (24 h± 2 h) and after PCI for 14 d.Results There were 2 patients in group I, 1 in group II and 3 in group III dropped out from the study because they cannot bear ECP or their disease exacerbated. The levels of hs-CRP, ICAM-1 and VCAM-1 increased in 3 groups 1 d after PCI compared with those 1 d before PCI (P<0.05). The levels of hs-CRP, ICAM-1 and VCAM-1 decreased in group II and group III compared with group I after treatment for 14 d (P<0.05), and decreased in group III compared with group II (P<0.05).Conclusion Danhong Injection combining ECP can reduce the levels of inflammatory factors in patients with ACS after PCI.

目的 探讨不同剂量奥美沙坦酯治疗原发性高血压并微量蛋白尿的效果.方法 160例高血压合并微量蛋白尿病人,给予奥美沙坦酯20 mg/d,2周后监测血压.将血压未达标病人122例随机分为2组,Ⅰ组60例,给予奥美沙坦酯20 mg/d+苯磺酸氨氯地平5 mg/d;Ⅱ组62例,给予奥美沙坦酯40 mg/d.两组共治疗12周,治疗前后观察两组血压变化及微量蛋白尿水平.结果 两组治疗后血压及微量蛋白尿水平较治疗前明显下降,差异有显著性(t=13.306～42.183,P＜0.05);治疗后Ⅱ组与Ⅰ组相比,血压无明显差异(P＞0.05),但微量蛋白尿降低更明显(t=18.039,P＜0.05).结论 奥美沙坦酯具有肾脏保护作用,奥美沙坦酯40 mg/d较奥美沙坦酯20 mg/d联合苯磺酸氨氯地平5 mg/d降低微量蛋白尿效果更好.

目的 探讨长疗程体外反搏及短疗程体外反搏对稳定型心绞痛的疗效及炎症因子的影响.方法 将90例稳定型心绞痛患者随机分为Ⅰ组(常规治疗组)、Ⅱ组(短疗程反搏组)及Ⅲ组(长疗程反搏组),每组30例.Ⅰ组接受常规治疗,Ⅱ组接受常规治疗及15 d体外反搏治疗,Ⅲ组接受常规治疗及35 d体外反搏治疗.治疗35 d后对三组的治疗效果进行评价,用免疫比浊法测定治疗前后血中CRP水平.结果 Ⅰ组有效率55.2％,Ⅱ组有效率90.0％,Ⅲ组有效率93.1％.Ⅰ组治疗前后对比,CRP水平无明显变化;与治疗前对比,Ⅱ组、Ⅲ组治疗后CRP水平明显下降,且差异有统计学意义(P＜0.05),但两组组间比较差异无统计学意义(P＞0.05).结论 长疗程体外反搏与短疗程体外反搏在治疗稳定型心绞痛方面疗效相近,均优于单药治疗.

Objective To discuss the curative effect and safety of olmesartan on chronic heart failure (CHF). Methods The CHF patients (n=120, male 50 and female 70) were chosen from the Cardiovascular Hospital affiliated to Qingdao University Medical College from Nov. 2011 to Oct. 2013. All patients were divided into groupⅠand groupⅡ(each n=60) according to random digits table. All groups were treated with routine therapy (individualized administrations of cardiotonics, diuretics, aldosterone receptor antagonist andβ-receptor blockers), and group Ⅰ was additionally given olmesartan, and group Ⅱ, valsartan for 8 w. The changes of LVEDd and LVEF, level of N-terminal pro brain natriuretic peptide (NT-proBNP), blood pressure (BP) and renal function were detected in 2 groups before and 8 w after treatment. Results After treatment, LVEDd decreased in groupⅠ[(58.5 ±6.4) mm vs. (52.2±6.0) mm] and groupⅡ(58.2±5.9) mm vs. (52.8±5.8) mm], and LVEF increased in groupⅠ[(39.2±5.2)%vs. (52.1±3.8)%] and groupⅡ[(39.8±6.0)%vs. (50.6±2.7)%, all P<0.05]. After treatment, NT-proBNP decreased significantly in groupⅠ[(934.0±217.7) pg/ml vs. (184.7±66.6) pg/ml] and groupⅡ[(935.0 ±224.6) pg/ml vs. (191.6±70.2) pg/ml, all P<0.05]. After treatment, BP decreased significantly in groupⅠand groupⅡ(all P<0.01). Conclusion Olmesartan can improve heart function and reduce level of NT-proBNP in CHF patients, and its curative effect is not worse than that of valsartan.

Objective By observing the influence of al1-trans retinoic acid(ATRA) on intimal proliferation and the expression of NF-κB and P-selecting in atherosclerotic plaques in rabbits to probe into the possible anti-inflammatory machanism.Methods 54 New Zealand rabbits were randomly divided into 3 groups:sham-operation groups(A,B,C),contrast groups(A,B,C),treatment groups(A,B,C).There were 6 rabbits in each group.The sham-operation groups were fed with conventional chow,and underwent surgery without endothelium injury;The contrast groups were fed with high cholesterol chow and subjected to carotid endothelial injury by air desiccation after 2 weeks;The treatment groups were administered ATRA daily by gavage,and other measures were the same as the contrast groups.The rabbits in groups A,B and C were killed respectively after 7,14 and 28 days since the surgery.The carotid artery segments were harvested for histomorphometry observation and determination,and immunohistochemistry was used to detect the expressions of NF-κB and P-selectin.Results(1)The thickening of intima was not found in the sham-operation groups and the expressions of NF-κB and P-selecting was micro-scale.(2)In the contrast groups,the thickening of intima was found in carotid artery after 7 days since surgery,and severe thickening of intima and atherosclerotic plaques were found after 14,28 days.The expressions of NF-κB and P-selecting of contrast groups were significantly detected.(3)In the treatment groups,the intimal area,intimal/medial area ratio and maximum plague thickness of the artery after 14,28 days since the surgery were lower than the contrast groups(P<0.05),and the expressions of NF-κB and P-selecting were lower,too(P<0.05).Conclusion The results show that ATRA can inhibit neointimal formation after carotid endothelial injury in rabbits,and the possible mechanism is that ATRA inhibits the acivation and expression of NF-κB and then decreases the expression of P-selecting which is regulated by NF-κB and ultimately inhibits the inflammation.

Objective To investigate the influence of all-trans retinoic acid(ATRA) on the neointimal formation,vascular remodeling,the expression of Cdk2 in carotid atherosclerosis in rabbits.Methods Thirty-six New Zealand rabbits were randomly divided into 3 groups: normal group(n=12),control group(n=12) and ATRA-treated group(n=12).The control group and ATRA-treated group were fed with high-cholesterol diet and two week's later they were induced into carotid atherosclerosis using air-drying technic.ATRA-treated group was predosed with ATRA by gavage 3 days before surgery.All rabbits were killed one week or four weeks after surgery.Using immunohistochemiscal staining,the harvested target vessels were measured the protein expression of Cdk2 and proliferation cell nuclear antigen PCNA.Meanwhile vessel morphological measurement was taken for all target vessels.Results(1) In normal group,Cdk2 and PCNA could not be detected in the target vessels.(2)In control group,there was a distinct intima hyperplasia and narrowed luminal area at six weeks after surgery.The expressions of PCNA and Cdk2 were significantly intense.(3) In ATRA-treated group,the Cdk2 expression was markedly lower than that in control group.And there was an outstanding smaller intima/media area ratio and larger luminal area in ATRA-treated group.(4) The PCNA expression and Cdk2 expression are in remarkable positive correlation.Conclusions ATRA could inhibit Cdk2 expression and VSMC proliferation,therefore it could reduce intima proliferation and elicit favorable geometric remodeling of the carotid atherosclerosis in rabbits.

Purpose: To investigate the influence of all-trans retinoic acid (ATRA) on the process of neointimal formation, vascular remodeling, the expression of C-myc in carotid atherosclerosis in rabbits. Methods: Thirty-six New Zealand rabbits were randomly divided into 3 groups: normal group(n = 12), control group(n= 12), and ATRA-treated group (n = 12). The last two groups were fed by high-cholesterol diet. Control and ATRA-treated group were made into carotid atherosclerosis model using air-drying after two weeks. ATRA-treated group were predosed with ATRA by gavage 3 days before surgery. All rabbits were killed one week and four weeks after surgery. After the target vessels were harvested, we used immunohistochemistry staining to measure the protein expression of C-myc and proliferation cell nuclear antigen PCNA. Meanwhile vessel morphological measurement were taken. Results: Circled digit one In normal group, C-myc and PCNA were not detected. Circled digit two In control group, there were distinct neointima formation and narrow luminal area in six weeks and the expression of PCNA, C-myc are significantly high. Circled digit three In ATRA-treated group, the expression of C-myc were significantly lower than in control group, ATRA-treated group had an outstanding smaller neointima/media area ratio and larger luminal area. Circled digit four The expression of PCNA and C-myc were in remarkable positive correlation. Conclusions: Inhibiting VSMC proliferation by inhibiting the expression of C-myc may be one mechanism by which ATRA reduced neointima formation and elicited favorable geometric remodeling of the carotid atherosclerosis in rabbits.